Chickenpox

Chickenpox

Chickenpox is so easily caught that it is almost a natural hazard of childhood. The illness does not last long, hardly ever has serious complications and looking after the patient at home is a simple matter.

Most of us will have had chickenpox at some time during our childhood and most of the children we know will catch it at some stage. It is a common illness and rarely has serious complications so there is no immunization programme to prevent it. Once you've had it you will have a natural immunity against a second attack.

The medical name for chickenpox is varicella. It occurs mainly in children and is highly infectious. It is easily recognized by the rash it causes. Babies acquire a natural immunity to the infection from their mothers but this resistance wears off by the age of two or three. After this age a child is likely to catch the infection from other children, generally before the age of ten.
THE VIRUS
The virus (or germ) that causes chickenpox is the same one that causes shingles in adults. An adult with shingles can give a child chickenpox, just as a child with chickenpox can give a grown-up person the shingles virus. Outbreaks of chickenpox are strongest in the autumn and winter and seem to occur in three- to four-year cycles as new groups of children lose their inborn resistance.

The virus is spread from person to person, usually by personal contact or by droplet infection. Clusters of the virus are contained in the tiny droplets of water that are exhaled as a matter of course with every breath. When another child breathes in an infected droplet, the virus starts to multiply and another case of chickenpox begins.
FIRST SYMPTOMS
Once the virus enters the body, it will spread after an incubation period of ten days to three weeks. The first a child will know of his or her illness will be a 24-hour period of vague headache, feeling unwell, occasional slight fever and sometimes a blotchy red rash which quickly fades. A mother may note that her child is 'off colour' or 'sickening for something'.

Within 24 hours spots appear. The first ones appear in the mouth and throat where they quickly burst, causing pain and soreness. Spots then appear on the trunk and face, with only relatively few on the arms and legs.
THE SPOTS GROW
The spot starts as a pink pimple which within five or six hours becomes raised to form a tiny blister, or vesicle, containing clear fluid which is full of viruses. These 'teardrop' spots gradually become milky in colour. Then they form a crust and finally a scab. The time from the appearance of the teardrop to the formation of the scab is only about 24 hours. During this period the child may be fretful and run a temperature of 38°C (100° or 101°F).

Some children have only 30 or 50 spots, while others may have several hundred. Immediately the crust forms, the spots begin to itch and this may last until the scabs drop off, leaving normal skin, after one or two weeks.
TREATMENT
Children with a high temperature who feel unwell may prefer to stay in bed or lie downstairs in a warm room. There is no need to enforce strict bed rest. Any pain from a sore throat or headache is best relieved with a painkiller such as paracetamol.

Apply calamine lotion which has a cooling and anti-itching effect. Alternatively, constant itching can be reduced with an antihistamine drug, precribed by your doctor.

Scabs start to disappear after ten days and most children will be completely clear of spots in two weeks. Serious complications, although rare, include skin infections, pneumonia (usually in adults) and (very rarely) encephalitis.

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